MetLife Auto & Home Group takes a bite out of fraud.Technology is a key weapon in MetLife Auto & Home Group's fight against fraud. Earlier this year, the group, a unit of MetLife Inc., rolled out the @FIRST system to help automate To turn a set of manual steps into an operation that goes by itself. See automation. screening of its automobile claims for potential fraud. The company co-developed the system with Computer Sciences Corp. @FIRST employs data mining and other technologies to analyze an·a·lyze v. 1. To examine methodically by separating into parts and studying their interrelations. 2. To separate a chemical substance into its constituent elements to determine their nature or proportions. 3. claims with the help of several engines--a modeling engine that creates models to compare new claims against a template (1) A pre-designed document or data file formatted for common purposes such as a fax, invoice or business letter. If the document contains an automated process, such as a word processing macro or spreadsheet formula, then the programming is already written and embedded in the based on instances of previous fraudulent The description of a willful act commenced with the Specific Intent to deceive or cheat, in order to cause some financial detriment to another and to engender personal financial gain. claims; an identity search engine that analyzes particular data in current claims that match other data fields; and a business-rules engine that applies indicators of fraud, such as length of time in reporting a claim. The company enters data into the Web-based system each evening. By the next morning, analysts or special investigation unit supervisors are alerted of the claims' scores, which might signal potential fraud, said John Sargent
Losses generated from insurance fraud continue to escalate es·ca·late v. es·ca·lat·ed, es·ca·lat·ing, es·ca·lates v.tr. To increase, enlarge, or intensify: escalated the hostilities in the Persian Gulf. v.intr. across the industry. Fraud causes about $27 billion in property/casualty losses each year, which acids to the premium paid by all insureds, Sargent said. "And while about 10% to 15% of claims are affected, the industry uncovers only less than 1%," he said. MetLife Auto & Home relied on claims representatives to detect fraud, but pressure for them to provide quality customer service and pay claims was one reason it moved to a technology-based fraud-detection system. |
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